Painful Sexual Intercourse

Are you one of those women who experience painful intercourse or pain from any type of vaginal penetration? If you are, you are hardly alone.  A recent survey indicates that more than 20% of women in the United States experience painful intercourse and that number rises significantly in post-menopausal women. As someone who experienced and endured pain during sex for more than 20 years, this is an issue that is near and dear to my heart.  It is also the subject for my next book and educational series.

Typical symptoms from painful intercourse include:

  • Sharpness and burning during penetration particularly around the entroitus (opening to the vagina)
  •  Tightening of the vaginal muscles (this can happen well before penetration).  Sometimes the muscles get so tight that penetration is impossible.
  • Extreme vaginal dryness.  I have heard it described as  feeling like you have sandpaper in your vagina.

The medical establishment calls pain during penetration Vaginismus, which is an involuntary contraction of the muscles around the vaginal opening, causing insertion of any object such as a finger, penis, toy, speculum, very painful.  Hormonal changes, particularly post-menopause, can cause dryness and a thinning of the vaginal lining, which can lead to discomfort.  However, not ever woman has this issue and I have seen plenty of post menopausal women, particularly those who are very sexually active, who have no issues with vaginal dryness what so ever.

In over 90% of women, painful intercourse is caused by a combination of psychological factors resulting in a learned response that penetration equals pain.  Here are the most common reasons for painful intercourse:

  •  Early negative sexual experiences.  This can range from shame as a result of being caught masturbating to being the victim of sexual abuse or predatory acts without any actual touching.  Growing up in any type of abusive household (alcohol, physical abuse) frequently leads to sexual issues, including painful sex.
  • Fear of painful intercourse— A very common self-fulfilling prophesy
  • Fear of getting pregnant or getting STDs.
  • Physical trauma after childbirth, gynecological surgery, or repeated urinary tract or vaginal infections.
  • Inability to relax and get aroused
  • Performance anxiety typically around inability to orgasm
  • Lack of connection and trust with your partner
  • Body shame issues

There are some medical reasons that cause painful intercourse besides hormonal imbalances.  The most common reason is an untreated vaginal infection which should be ruled out before treatment begins.

Here’s the good news:  You do not need to suffer anymore or to stop having sex altogether!  There are treatment regimens available, including the one that I offer, that will help you to learn how to relax and enjoy sex.  My treatment usually involves a combination of

  • somatic therapy to work through any traumas that are stored in the body’s memory
  • easing anxiety by using breath, sound, and movement to relax the body and get you out of your head
  • education around female anatomy and changes during arousal
  • body work to help  understand your own unique arousal pattern

If you are in a partnership, I always encourage your partner to participate in some of the sessions as their support during the healing process and in carrying out the homework is critical.  Typically clients begin to see some improvement after six or seven sessions, although  everyone is on their own time table.

Please reach out to me if this article resonates with you and by all means share it will all your female friends. No one should have to suffer or put up with painful sex.  And for those of you who do not live in the SF Bay area, I do lots of work  very successfully via Skype.

Here’s to having joyous, exhilarating, pain-free sex!





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